重组人粒细胞集落刺激因子干预对恶性肿瘤放化疗患者医院感染及免疫功能的影响
|
摘要
目的分析恶性肿瘤放化疗患者接受重组人粒细胞集落刺激因子干预后,对其医院感染和免疫功能的影响。方法选取2015年7月-2017年7月医院收治的行恶性肿瘤放化疗患者400例作为研究对象,按照随机数字表法分为试验组和对照组,每组200例。对照组患者放化疗后采用常规临床护理。试验组患者在对照组基础上同时给予重组人粒细胞集落刺激因子治疗。连续治疗4周后,比较两组患者医院感染发生情况,中性粒细胞计数及T淋巴细胞亚群水平指标的差异。结果试验组患者放化疗后接受重组人粒细胞集落刺激因子干预治疗后,中性粒细胞计数(绝对值)、T淋巴细胞亚群水平升高幅度均优于对照组,试验组中性粒细胞恢复时间(5.35±1.21)d短于对照组的(11.21±1.19)d,两组比较差异有统计学意义(P<0.05);试验组患者血清中炎症因子肿瘤坏死因子(TNF-α)、干扰素-γ(IFN-γ)、C-反应蛋白(CRP)以及白介素-2(IL-2)水平降低幅度均优于对照组(P<0.05)。结论重组人粒细胞集落刺激因子可以改善患者体内细胞的活性状态,不仅有利于提高患者放化疗后身体免疫机制的效能,降低患者发生医院感染,进一步提升了患者治疗的效果和生活质量。
OBJECTIVE To observe the impact of recombinant human granulocyte colony-stimulating factor(rhGCSF)intervention on nosocomial infection and immune function of malignant tumor patients undergoing chemoradiotherapy.METHODS A total of 400 patients with malignant tumors who underwent chemoradiotherapy in the hospital from Jul 2015 to Jul 2017 were recruited as the study objects and randomly divided into the experimental group and the control group,with 200 cases in each group.The control group was treated with conventional clinical nursing after the chemoradiotherapy,while the experimental group was treated with additional rhG-CSF on basis of treatment of the control group.After the treatment for 4 consecutive weeks,the incidence of nosocomial infection,neutrophils counts and levels of T lymphocytes subsets were observed and compared between the two groups of patients.RESULTS The neutrophils counts(absolute value)and levels of T lymphocytes subsets(CD3+,CD4+,CD8+)of the experimental group were elevated more significantly than those of the control group after the rhG-CSF intervention.The time of recovery of neutrophils counts of the experimental group was(5.35±1.21)days,significantly shorter than(11.21±1.19)days of the control group(P<0.05).The levels of serum inflammatory factors tumor necrosis factor(TNF-α),interferonγ(IFNγ),C-reactive protein(CRP)and interleukin-2(IL-2)of the experimental group were reduced more significantly than those of the control group(P <0.05).CONCLUSIONThe rhG-CSF may improve the activated state of cells in vivo,boost the immune function of the patients after the chemoradiotherapy,remarkably reduce the incidence of nosocomial infection and further improve the curative effect and quality of life of the patients.
OBJECTIVE To observe the impact of recombinant human granulocyte colony-stimulating factor(rhGCSF)intervention on nosocomial infection and immune function of malignant tumor patients undergoing chemoradiotherapy.METHODS A total of 400 patients with malignant tumors who underwent chemoradiotherapy in the hospital from Jul 2015 to Jul 2017 were recruited as the study objects and randomly divided into the experimental group and the control group,with 200 cases in each group.The control group was treated with conventional clinical nursing after the chemoradiotherapy,while the experimental group was treated with additional rhG-CSF on basis of treatment of the control group.After the treatment for 4 consecutive weeks,the incidence of nosocomial infection,neutrophils counts and levels of T lymphocytes subsets were observed and compared between the two groups of patients.RESULTS The neutrophils counts(absolute value)and levels of T lymphocytes subsets(CD3+,CD4+,CD8+)of the experimental group were elevated more significantly than those of the control group after the rhG-CSF intervention.The time of recovery of neutrophils counts of the experimental group was(5.35±1.21)days,significantly shorter than(11.21±1.19)days of the control group(P<0.05).The levels of serum inflammatory factors tumor necrosis factor(TNF-α),interferonγ(IFNγ),C-reactive protein(CRP)and interleukin-2(IL-2)of the experimental group were reduced more significantly than those of the control group(P <0.05).CONCLUSIONThe rhG-CSF may improve the activated state of cells in vivo,boost the immune function of the patients after the chemoradiotherapy,remarkably reduce the incidence of nosocomial infection and further improve the curative effect and quality of life of the patients.
引文
[1]左金曼,夏瑞祥.重组人粒细胞集落刺激因子联合抗生素治疗急性白血病化疗后中性粒细胞缺乏合并感染患者的疗效[J].中国老年学杂志,2016,36(20):5064-5066.
[2]王环,李惠平,宋国红,等.预防性使用粒细胞集落刺激因子对乳腺癌辅助化疗所致中性粒细胞减少的影响[J].肿瘤,2016,36(11):1239-1245.
[3]刘娜,张淑英,周虹,等.重组人粒细胞集落刺激因子联合伊曲康唑治疗血液病患者侵袭性真菌感染的临床研究[J].中华医院感染学杂志,2015,25(13):2990-2992.
[4]辛文秀,陈凌亚,王增,等.浙江地区11家医院2009-2014年肺癌患者升白细胞药物应用分析[J].中国药房,2016,27(8):1020-1023.
[5]Vemula S,Thunuguntla R,Dedaniya A,et al.Improved production and characterization of recombinant human granulocyte colony stimulating factor from E.coli under optimized downstream processes[J].Protein Expr Purif,2015,108:62-72.
[6]吴旦平,张红丹,汪波.PEG-rhG-CSF注射液对乳腺癌术后化疗致中性粒细胞减少的防治效果[J].重庆医学,2018,47(4):546-548.
[7]Tiwari D,Haque S,Jawed A,et al.Efficient purification of rhG-CSF and its PEGylated forms and evaluation for in vitro activities[J].Protein Pept Lett,2015,22(10):877-884.
[8]Behi J,Hassiki R,Said NB,et al.Optimization of PEGylation reaction time and molar ratio of rhG-CSF toward increasing bioactive potency of monoPEGylated protein[J].Int J Biol Macromol,2018,109:888-895.
[9]晏妮,吴胜林,杜霞,等.肿瘤患者使用重组人粒细胞集落刺激因子DUE标准的建立与应用[J].中国药房,2016,27(29):4050-4053.
[10]杨晟,何小慧,刘鹏,等.聚乙二醇化重组人粒细胞集落刺激因子预防化疗后中性粒细胞减少的有效性分析[J].中国肿瘤临床,2015,42(12):626-631.
[11]高天,刘佳勇,樊征夫,等.软组织肉瘤化疗聚乙二醇化重组人粒细胞集落刺激因子预防中性粒细胞减少临床观察[J].中华肿瘤防治杂志,2015,22(16):1313-1317.
[12]郭佳琳,黄莉美,谢意程,等.恶性肿瘤患者医院感染多药耐药菌的药敏结果及危险因素分析[J].中华医院感染学杂志,2017,27(10):2194-2197.
[13]Xu B,Tian F,Yu J,et al.A multicenter,randomized,controlled,phase clinical study of PEG-rhG-CSF for preventing chemotherapy-induced neutropenia in patients with breast cancer and non-small cell lung cancer[J].Zhonghua Zhong Liu Za Zhi,2016,38(1):23-27.
[14]李桃,龚光明,徐俊炜.恶性肿瘤化疗患者医院感染相关因素分析与临床干预[J].中华医院感染学杂志,2015,25(22):5178-5180.
[15]付雪松,曾惠敏,张霁,等.2006-2012年某肿瘤医院医院感染回顾性分析[J].中国感染控制杂志,2015,14(10):704-707.
[16]Xie J,Cao J,Wang JF,et al.Advantages with prophylactic PEG-rhG-CSF versus rhG-CSF in breast cancer patients receiving multiple cycles of myelosuppressive chemotherapy:an open-label,randomized,multicenter phase III study[J].
[2]王环,李惠平,宋国红,等.预防性使用粒细胞集落刺激因子对乳腺癌辅助化疗所致中性粒细胞减少的影响[J].肿瘤,2016,36(11):1239-1245.
[3]刘娜,张淑英,周虹,等.重组人粒细胞集落刺激因子联合伊曲康唑治疗血液病患者侵袭性真菌感染的临床研究[J].中华医院感染学杂志,2015,25(13):2990-2992.
[4]辛文秀,陈凌亚,王增,等.浙江地区11家医院2009-2014年肺癌患者升白细胞药物应用分析[J].中国药房,2016,27(8):1020-1023.
[5]Vemula S,Thunuguntla R,Dedaniya A,et al.Improved production and characterization of recombinant human granulocyte colony stimulating factor from E.coli under optimized downstream processes[J].Protein Expr Purif,2015,108:62-72.
[6]吴旦平,张红丹,汪波.PEG-rhG-CSF注射液对乳腺癌术后化疗致中性粒细胞减少的防治效果[J].重庆医学,2018,47(4):546-548.
[7]Tiwari D,Haque S,Jawed A,et al.Efficient purification of rhG-CSF and its PEGylated forms and evaluation for in vitro activities[J].Protein Pept Lett,2015,22(10):877-884.
[8]Behi J,Hassiki R,Said NB,et al.Optimization of PEGylation reaction time and molar ratio of rhG-CSF toward increasing bioactive potency of monoPEGylated protein[J].Int J Biol Macromol,2018,109:888-895.
[9]晏妮,吴胜林,杜霞,等.肿瘤患者使用重组人粒细胞集落刺激因子DUE标准的建立与应用[J].中国药房,2016,27(29):4050-4053.
[10]杨晟,何小慧,刘鹏,等.聚乙二醇化重组人粒细胞集落刺激因子预防化疗后中性粒细胞减少的有效性分析[J].中国肿瘤临床,2015,42(12):626-631.
[11]高天,刘佳勇,樊征夫,等.软组织肉瘤化疗聚乙二醇化重组人粒细胞集落刺激因子预防中性粒细胞减少临床观察[J].中华肿瘤防治杂志,2015,22(16):1313-1317.
[12]郭佳琳,黄莉美,谢意程,等.恶性肿瘤患者医院感染多药耐药菌的药敏结果及危险因素分析[J].中华医院感染学杂志,2017,27(10):2194-2197.
[13]Xu B,Tian F,Yu J,et al.A multicenter,randomized,controlled,phase clinical study of PEG-rhG-CSF for preventing chemotherapy-induced neutropenia in patients with breast cancer and non-small cell lung cancer[J].Zhonghua Zhong Liu Za Zhi,2016,38(1):23-27.
[14]李桃,龚光明,徐俊炜.恶性肿瘤化疗患者医院感染相关因素分析与临床干预[J].中华医院感染学杂志,2015,25(22):5178-5180.
[15]付雪松,曾惠敏,张霁,等.2006-2012年某肿瘤医院医院感染回顾性分析[J].中国感染控制杂志,2015,14(10):704-707.
[16]Xie J,Cao J,Wang JF,et al.Advantages with prophylactic PEG-rhG-CSF versus rhG-CSF in breast cancer patients receiving multiple cycles of myelosuppressive chemotherapy:an open-label,randomized,multicenter phase III study[J].